CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Baptist Beaumont Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $90
  • Cash Discount Price: $65
  • vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Baptist Beaumont Hospital is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $65. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.95x the Medicare baseline. Located in 3080 College Street, Beaumont, TX.
Cash / Self-Pay
$65

Average discount available for prompt cash payment at this facility.

Insurance Median
$90

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$95.19

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $95.19 (100%)
Cash / Self-Pay: $65 (68%)
Insurance Median: $90 (95%)
Cash: $65 (68% of Medicare)
Ins. Median: $90 (95% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $95.19 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Americhoice - All Plans $50 53%
Amerigroup - All Plans $50 53%
Community Health Choice - All Plans $50 53%
Medicaid / KanCare $50 - $65 53%
Tchp Chips - All Plans $50 53%
Aetna $56 - $258 59%
Ameri-Plus Ppo-All Plans $56 59%
Blue Cross Blue Shield $56 59%
Cigna $56 - $216 59%
Superior Health Plan Mcr Adv $56 59%
Texan Plus-All Plans $56 59%
Beacon Health - All Plans $57 60%
Superior Health Plan Comm - All Other Plans $65 68%
Texas Exchange Plans - All Plans $65 68%
Correctcare - All Plans $84 88%
Naphcare Inc - All Plans $84 88%
Texas School Health Benefits - All Plans $84 88%
Preferred Care Services - All Plans $96 101%
Brookshire Brothers - All Plans $127 133%
Signature Health - All Plans $155 163%
Central Healthcare Services - All Plans $248 261%
Humana $248 - $300 261%
Mhhnp-All Plans $248 261%
Imagine Healthcare (Smartcare) - All Plans $273 287%
Pponext - All Plans $323 339%
Multiplan - All Plans $348 366%
Phcs - All Plans $348 366%
First Health - All Plans $373 392%
Healthsmart - All Plans $373 392%
Managed Healthcare Inc - All Plans $373 392%
Blue Bell - All Plans $398 418%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3080 College Street, Beaumont, TX 77701
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals